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[潜在感染的新生儿]

[The potentially infected newborn infant].

作者信息

Sandoval Morón O J, Martínez Bracamontes G, Palacios Suárez E M, Jiménez Rojas D, Lizárraga Saucedo L, Potenciano Gutiérrez R, Capistrán Guadalajara A, Juárez Armendáriz M C, Sandoval Landívar J L

出版信息

Bol Med Hosp Infant Mex. 1979 Jan-Feb;36(1):23-43.

PMID:758182
Abstract

In order to establish relationship between premature rupture of membranes (RPM) and neonatal infection, together with the importance of other factors during this process, 50 newborns with history of RPM were studied. In a control group and in groups of newborns with less than and more than 24 hours of plain RPM, related to clinically healthy and vigorous infants, no case of infection was found. On the other hand, 30% and 60% respectively of infections were found in groups less than and more than 24 hours of RPM, but with the presence of other contaminating factors that impair immunological response of the newborn, such as: acute maternal infection, prolonged delivery, unexpected birth, pediatric reanimation procedures, organic immaturity, fetal suffering, immediatie neonatal depression and intercurrent pathology. There were two deaths: a case with RPM of 5 hours and another one with 38 hours, but both with high rating due to the presence and intensity of "aggravating factors" mentioned having internal action mechanism that apparently of restrains to the perpetuation of the hypoxia-acidosis cycle. A provisional sheet is presented to evaluate such "aggravating factors" considering that an RPM associated to them represents a high risk of neonatal infection. In cases of clinically healthy newborns with plain RPM, we advice only to watch over them for 3--5 day, but no antimicrobial treatment at all.

摘要

为了确定胎膜早破(RPM)与新生儿感染之间的关系,以及在此过程中其他因素的重要性,对50例有胎膜早破病史的新生儿进行了研究。在一个对照组以及胎膜早破时间少于24小时和多于24小时的新生儿组中,这些新生儿临床上健康且活力良好,未发现感染病例。另一方面,在胎膜早破时间少于24小时和多于24小时的组中,分别有30%和60%的感染病例,但存在其他损害新生儿免疫反应的污染因素,如:母亲急性感染、分娩时间延长、意外分娩、儿科复苏程序、器官不成熟、胎儿窘迫、新生儿即刻抑郁和并发疾病。有两例死亡:一例胎膜早破5小时,另一例38小时,但由于存在上述具有内在作用机制的“加重因素”及其强度,这两例均评分较高,这些因素显然抑制了缺氧 - 酸中毒循环的持续。给出了一个临时表格来评估此类“加重因素”,因为与之相关的胎膜早破代表着新生儿感染的高风险。对于临床上健康且有单纯胎膜早破的新生儿,我们建议仅对其观察3 - 5天,但完全不进行抗菌治疗。

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[The potentially infected newborn infant].[潜在感染的新生儿]
Bol Med Hosp Infant Mex. 1979 Jan-Feb;36(1):23-43.

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